Individual provider Active NPI

Amit Punni, M.D

  • Pediatrics Physician
  • Tacoma, WA
National Provider Identifier
1114597077
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD61567302 Issued in WA
Practice address
1608 S J St FL 2
Tacoma, WA 98405-4930
Phone
(253) 274-7503
Fax
(253) 274-7993
NPI assigned
Jul 1, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD61567302 WA Primary

Addresses

Primary practice location

1608 S J St FL 2
Tacoma, WA 98405-4930

Mailing address

1608 S J St FL 2
Tacoma, WA 98405-4930
Phone (253) 274-7503

Other identifiers 1

IdentifierTypeStateIssuer
2293192MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address apunni874105@fhsce.cathoichealth.net Direct Franciscan Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240823002621 WA Practitioner - Pediatric Medicine 3870032642 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD61567302WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Pediatrics CurrentSince Aug 1, 2024 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group Past Accepting new patients
Franciscan Health System Past Accepting new patients

Locations

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1114597077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 S J ST FL 2",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054930",
            "telephone_number": "253-274-7503",
            "fax_number": "253-274-7993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 S J ST FL 2",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054930",
            "telephone_number": "253-274-7503",
            "fax_number": "253-274-7993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNNI",
        "first_name": "AMIT",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-01",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD61567302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2293192",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apunni874105@fhsce.cathoichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1608 S J St Fl 2",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984054930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.